Long-term effect of mandibular midline distraction osteogenesis on the status of the temporomandibular joint, teeth, periodontal structures, and neurosensory function

Purpose: This study retrospectively evaluated the long-term effects of transverse symphyseal distraction osteogenesis (DO) on the temporomandibular joint (TMJ) symptoms, periodontal health, tooth vitality, and nerve injury after surgery. Patients and Methods: Twenty-three patients were treated with symphyseal DO during a 4-year period. Fifteen patients were available for follow-up from 7 to 45 months postoperatively (ave, 24.5 months). The patients were clinically evaluated for TMJ symptoms, periodontal pocket formation, tooth vitality and mobility, crestal bone loss, and attached gingival tissue changes. Radiographs of the mandibular anterior teeth were used to evaluate for periodontal bone loss, periapical lesions, or widening of the periodontal ligament (PDL). Results: Preoperatively, 47% of the patients had TMJ symptoms. No patient had symptom worsening or developed new symptoms postoperatively. Five patients' TMJ symptoms improved, and 3 experienced complete resolution of symptoms. No periodontal bone loss or soft tissue recession were evident. Tooth vitality was maintained in 13 patients. Two patients developed Class II mobility of 1 mandibular central incisor, 1 patient had tooth pain and a widened PDL adjacent to the osteotomy/corticotomy site, and 1 patient experienced mental nerve paresthesia. Conclusions: DO can be used to treat transverse discrepancies of the mandible with limited morbidity.